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PDMP & HITI Solution Planning Workgroup Session

PDMP & HITI Solution Planning Workgroup Session. May 22 , 2014. Solution Planning Work Group Approach. Goal is to prescribe a solution that would mitigate impact to the way PDMPs share data today. Context Diagram. HIE/ Pharmacy Intermediary. 5. 2. 2. 7. 4. Out of State PDMP.

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PDMP & HITI Solution Planning Workgroup Session

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  1. PDMP & HITI Solution Planning Workgroup Session May 22,2014

  2. Solution Planning Work Group Approach Goal is to prescribe a solution that would mitigate impact to the way PDMPs share data today.

  3. Context Diagram HIE/Pharmacy Intermediary 5 2 2 7 4 Out of State PDMP In-State PDMP EHR or Pharmacy System Hub 1 8 8 3 3 7 6 Hub = In Scope

  4. HIE/Pharmacy Intermediary 2 5 2 7 4 Out of State PDMP In-State PDMP EHR or Pharmacy System Hub 1 8 8 3 7 6 3 Hub PMP/HITI User Stories with Alternate Workflows EHR or Ph. to In-State PMP: 1a: EHR to In-state PMP 1b: Ph. to In-state PMP 2a: EHR to In-state PMP via HIE 2b: Ph. to In-State PMP via HIE 3a: EHR to In-state PMP via Hub 3b: Ph. Intermediary to In-State PMP via Hub EHR or Ph. to Out-of-State PMP: 1a+4: EHR to out-of-state PMP via In-state PMP 1b+4: Ph.to out-of-state PMP via In-state PMP 2a+4: EHR to out-of-state PMP via HIE & In-state PMP 2b+4: Ph. to out-of-state PMP via Ph. Int& In-state PMP 2a+5: EHR to out-of-state PMP via HIE 2b+5: Ph. to out-of-state PMP via HIE 3a+4: EHR to out-of-state PMP via Hub & In-State PMP 3b+4: Ph. to out-of-state PMP via Hub & In-State PMP 1a+8: EHR to out-of-state PMP via In-State PMP & Hub 1b+8: Ph. to out-of-state PMP via In-State PMP & Hub 3a+6: EHR to out-of-state PMP via Hub 3b+6: Ph. To out-of-state PMP via Hub

  5. Summary of Transactions

  6. Current In-State HIT Integrated System Workflows

  7. Current In-State EHR Workflow (Hub) Transaction 3a – Not Effective Workflow? Currently Active? In-State PDMP EHR System PMIX ? PDMP Hub ? ? • Notes: • Ohio, Kansas uses PMIX to connect to PMPi (data hub) • PMIX data model • *Future: PMP Gateway – centralize translations (endpoints can communicate with gateway) • Kansas pilots – EHR provides translation from HL7 (V2/ADT?) to PMIX • AI Clay/Jeff – Verify translation/EHR generating PMIX request • Hub functions as aggregator, depending on arrangements Legend Request Response

  8. Current In-State Pharmacy Workflow (Hub) Transaction 3b – Not Effective Workflow? Currently Active? In-State PDMP Pharmacy System ? ? PDMP Hub ? ? • Notes: Legend Request Response

  9. Current Interstate HIT System Workflow

  10. Current Interstate EHR Workflow Transaction 2a + 7a + 6 EHR System HIE In-State PDMP Third Party Software PMIX-NIEM NCPDP SCRIPT (Medication History) PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM • Notes: • Indiana, North Dakota (HIE-Hub) • AI Jinhee: Verify Indiana translation • HIE translates using NCPDP SCRIPT with PMIX wrapper for Hub • Parking lot item: Ambulatory vs. Acute (different standards for different EHR systems?); In-hospital pharmacies vs. retail pharmacies • AI Danna Droz/Chad Garner: Confirm third party software functionality – NARxCheck via NABP Out-of-State PDMP PDMP Hub PMIX-NIEM Legend Request Response

  11. Current Interstate Pharmacy Workflow Transaction 2a + 2b + 7a + 7b + 6 HIE In-State PDMP Pharmacy System Third Party Software PMIX Wrappers NCPDP SCRIPT PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Pharmacy Int. / Switch NCPDP SCRIPT PDMP Hub Out-of-State PDMP PMIX-NIEM ? Legend Request ? Response • Notes:

  12. Questions to be answered: Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted? How do we define intermediaries and their relationships to Health IT systems? What components of PDMP report are extracted for decision support? Can EHR and Pharmacy IT systems handle the proposed standards (in the context of PDMP systems)? What standard(s) fit into message and workflow configuration per transaction type? Are transactions collapsible in terms of capability of leveraging same standard? Are all transactions necessary? Differences between retail and in-hospital pharmacies workflow/architecture? What is the cost associated with the proposed solutions? How do we define an aggregator? (collection of response from different PDMPs back to recipient) Parking lot item: Ambulatory vs. Acute (different standards for different EHR systems?); In-hospital pharmacies vs. retail pharmacies

  13. Next Steps:1. Confirm relevant transactions-standards pairings for segmented data exchange workflows2. Review and clarify System-Transaction Relationship workflow

  14. Appendix

  15. System Transaction-Relationship Flow Legend Known To Confirm

  16. Current In-State EHR Workflow (Direct) Transaction 1a EHR System In-State PDMP PMIX? Legend Request Response

  17. Current In-State EHR Workflow (HIE) Transaction 2a HL7 A04 NCPDP SCRIPT with PMIX Wrappers Third Party Software HL7 ADT feeds NCPDP SCRIPT EHR System HIE In-State PDMP HL7 OBX XML Report NCPDP SCRIPT XML Response NCPDP SCRIPT with PMIX Wrapper Legend Request Response

  18. Current In-State Pharmacy Workflow (Direct) Transaction 1b Pharmacy IT System In-State PDMP Legend Request Response

  19. Current In-State Pharmacy Workflow (Pharmacy Int. / Switch) Transaction 2b NCPDP SCRIPT (Medication History) ? Pharmacy System Pharmacy Intermediary/ Switch In-State PDMP NCPDP SCRIPT (Medication History) ? • Notes: • SureScripts: Not live today (intermediary to PDMP) but may be a future state • Does not include PDMP but is part of a future enhancement to provide requestor Legend Request Response

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